Smarter spending

Introducing Centre for Progressive Policy's new research programme in health

26 March 2024

By Tanya Singh

4 minute read

The Centre for Progressive Policy (CPP) has previously shown through its research that health spending in the UK would need to increase by at least £50 billion a year by 2030 just to maintain current levels of provision, owing to an ageing population and ever-increasing cost pressures. In the face of real concerns around fiscal sustainability and the tight budget environment, it becomes imperative to look at how we can draw the most value from our current spending programmes. The goal is making sure that every penny is put to good use, especially when it comes to healthcare. CPP is stepping up to the challenge with a new project that seeks to find smarter ways to invest in our nation’s health.

Whichever political party wins the next election, they will have a huge challenge on their hands keeping up with the necessary funding for public services and health, with neither party being honest with the electorate about how they are going to do this. The 2024 Spring Budget announced an increase of £2.5bn for health but adjusting for inflation, planned total health care spending in 2023/24 will be 3.2% less in real terms than in 2022/23 (£6bn). At a minimum, we must make sure we're using what we have wisely.

As we embark on this journey, we will be diving deep into the numbers to evaluate how effectively our current health system translates public spending into positive health outcomes compared to other countries, and how things have changed over time and why. By comparing data from different countries across the OECD, we are aiming to uncover what's working and what's not, so we can learn from the best and improve where needed. While England was once recognised as one of the world's most efficient health systems, recent challenges to funding and staffing warrant a reassessment of its current status.

Historically, NHS England has received more research attention than the healthcare systems of Northern Ireland, Wales, and Scotland. But following devolution, each UK country has developed distinct health policies. Have these divergent approaches influenced healthcare efficiency? If so, what lessons can be learned? This project seeks to address this gap in research and provide valuable insights into the performance of healthcare systems across the UK.

There are two other major gaps that this project shall aim to fill. For a very long-time performance of health systems has been measured in terms of how much healthcare is produced, akin to the production of outputs by firms. For instance, most studies will rank a country as efficient if it treats a greater number of patients, but this may not always translate into good health; what instead we should be doing? In this project, our focus will be on outcomes rather than outputs. We aim to assess how effectively we're improving overall population health and whether we can do so in a more cost-efficient way.

Lastly, the project focuses on how we can leverage non-health policies to improve health outcomes. Tackling health issues isn't just about doctors and hospitals; it's about everything from housing policy to education policy to the environment. Social scientists have long known the role that "social" factors like poverty, unemployment and education are correlated with health. For instance, at CPP, we have often talked about the role played by socioeconomic inequality in determining health. But, little research has been carried out to understand whether it is actually possible to improve population health by addressing these non-health factors with social policies. With this project, we will look to investigate the potential of social policies in improving health system efficiency. The key message here is that a better health system may not have to be just about pumping more money into healthcare but rather a more rounded "health in all policies" strategy.

Ultimately, our project is not just about scrutinising healthcare spending; it's about redefining how we approach health as a nation and taking a comprehensive approach, drawing from international best practices on the way. Our aim is clear: to find smarter, more efficient ways to invest in the well-being of our population while navigating the challenges of fiscal sustainability and tight budgets.